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21 Cards in this Set
- Front
- Back
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Name the 2 major anticoag compounds |
1. antiplatelet 2. anticoagulant |
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How do antiplatelets work?? |
-they prevent the initial plug formation; injury to vascular walls causes PLTs to aggregate and form plug this plug them attract other substances (fibrin) to make plug stronger forming a clot |
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Name the antiplatelet agent classes |
- COX inhibitors -Phosphodiestase inhibitors -ADP inhibitors -Gylcoprotein IIb/IIIa Receptor Antagonists |
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COX inhibitors |
inhibit formation of PG-I2(vasocon) and Thromboxnes (plt activation)
such a ASA- main effect on PTs other NSAIDS |
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Phosphodiesterase Inhibitors |
phosphodiesterase breaks down cAMP. high level cAMP inhibit PLT agger therefore phosphodiesterase inhibtors prevent break down of cAMP keeping levels high and inhibiting plt agg. |
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What controls cAMP levels??? |
TX-A2 (Thromboxanes)
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Name a Phosphodiesterase inhibitor |
Dipyridamole (Persantine)
given with warfarin but can cause cardiac steal |
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Explain ADP inhibitors |
-ADP inhibits the formation of cAMP so stopping ADP allows formation of cAMP= inhibition of plt agg. |
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Name the 2 ADp inhibitors |
1. Cloidogrel (Plavix) 2. Ticlopidine |
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Explain Glycoprotein IIb/IIIa antagonist |
- glycoprotein receptors are located on plts and bind fibrinogen allowing plt agg |
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Name 3 glycoprotein IIb/IIa receptor antagonist |
1. Abciximab (ReoPro) 2. Eptifibatide (Integrilin) 3. Tirofiban (Aggrastat) |
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Thrombin Inhibitors |
- used to in place of heparin Hirudin & Bivalirudin (Angiomax) |
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HEPARIN |
- found in mast cell & nerve terminal vesicles -polyionic -requires co factor -ntithrombin III -50% metabolized -not absorbed in GIT |
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Explain Heparins structure |
strongly acidic glycosaminoglycan high molecular weight 10-100monosaccharide |
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Is heparin safe to give in pregnancy?? |
yes it does not cross placenta |
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what is the reversal for heparin?? |
Protomine |
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LMWH |
Enoxaparin Dalteparin Fondaparinux
cleaved from heparin |
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Oral Anticoagulants |
- derivaties of Coumarin -they competitive inhibitors of vit K which is needed for synthesis of prothrombin
(prothrombin is converted into thrombin which converts fibrinogen into fibrin which stabilizes clot
- slow onset |
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Warfarin |
reversal is vitmin K or FFP to provide prothrombin
-CROSSES PLACENTA |
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THROMBOLYTIC AGENTS |
-main use is actue conronary occlusion -converts plasminogen to plasmin which cleaves fibrin |
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Name 3 fibrinolytics |
1. streptokinase 2. Alteplase 3. Urokinase |
